A recent PLoS article [html] has made a persuasive argument that controlling for a single variable in the HIV epidemic can neutralize any potential benefit from male circumcision. The study suggests targeting said variable would be far more effective than a messy, ethically questionable, and expensive mass male circumcision campaign.

The study’s author, John R. Talbott, concludes that the size of the female sex worker population and their operation outside any regulatory environment are the drivers of the epidemic rather than low levels of male circumcision.

I find it extraordinarily interesting that highly sexually regimented societies or those with a history of such regimentation, primarily Muslim and Catholic countries, have a relatively controlled level of HIV infection. Post-modern or less religious countries such as those of Northern Europe and eastern countries, many with a Buddhist tradition, have moved quickly to stem the tied of HIV infection, and therefore also enjoy relatively low levels of infection from successful anti-HIV programs.

Sub-Saharan Africa has neither the tradition of sexual regimentation nor the reality of a post-modern/Buddhist society. Wouldn’t it be worth studying these problems of sociology to determine the drivers of the epidemic? Clearly, the Talbott article is a valuable contribution in this direction.

What is an intactivist?

noun
1. an especially active, vigorous advocate of children's rights, especially the right to genital integrity or the right to be free from genital cutting (circumcision).

adjective
2. of or pertaining to intactivism or intactivists: an intactivist organization for the right of male, female, and intersex children to be free from genital cutting.

3. advocating for children by vigorously opposing genital cutting (circumcision), especially the cutting of children who lack capacity to consent: Intactivist opponents of the American Academy of Pediatrics picketed their annual conference in New Orleans.